{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:51:28Z","timestamp":1792093888720,"version":"4.4.0"},"reference-count":35,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Social Science & Medicine"],"published-print":{"date-parts":[[2026,12]]},"DOI":"10.1016\/j.socscimed.2026.119899","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T23:14:50Z","timestamp":1791501290000},"page":"119899","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Medical need or moral hazard? Public insurance transitions and healthcare utilization in South Korea"],"prefix":"10.1016","volume":"410","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0285-7644","authenticated-orcid":false,"given":"Changyon","family":"Han","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9652-7004","authenticated-orcid":false,"given":"Hyunsub","family":"Kum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.socscimed.2026.119899_bib1","first-page":"208","article-title":"A framework for the study of access to medical care","volume":"9","author":"Aday","year":"1974","journal-title":"Health Serv. Res."},{"issue":"7","key":"10.1016\/j.socscimed.2026.119899_bib2","doi-asserted-by":"crossref","first-page":"928","DOI":"10.4040\/jkan.2012.42.7.928","article-title":"Multilevel analysis of health care service utilization among medical aid beneficiaries in Korea","volume":"42","author":"Ahn","year":"2012","journal-title":"J. Korean Acad. Nurs."},{"issue":"4","key":"10.1016\/j.socscimed.2026.119899_bib3","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1080\/07370016.2011.614837","article-title":"Factors associated with the overuse or underuse of health care services among medical aid beneficiaries in Korea","volume":"28","author":"Ahn","year":"2011","journal-title":"J. Community Health Nurs."},{"issue":"1","key":"10.1016\/j.socscimed.2026.119899_bib4","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2307\/3349613","article-title":"Societal and individual determinants of medical care utilization in the United States","volume":"51","author":"Andersen","year":"1973","journal-title":"Milbank Meml. Fund Q. - Health & Soc."},{"issue":"1","key":"10.1016\/j.socscimed.2026.119899_bib5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2307\/2137284","article-title":"Revisiting the behavioral model and access to medical care: does it matter?","volume":"36","author":"Andersen","year":"1995","journal-title":"J. Health Soc. Behav."},{"issue":"4","key":"10.1016\/j.socscimed.2026.119899_bib6","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1162\/REST_a_00518","article-title":"Moral hazard in health insurance: do dynamic incentives matter?","volume":"97","author":"Aron-Dine","year":"2015","journal-title":"Rev. Econ. Stat."},{"key":"10.1016\/j.socscimed.2026.119899_bib7","first-page":"941","article-title":"Uncertainty and the welfare economics of medical care","volume":"53","author":"Arrow","year":"1963","journal-title":"Am. Econ. Rev."},{"issue":"4","key":"10.1016\/j.socscimed.2026.119899_bib8","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1093\/jeea\/jvy017","article-title":"Moral hazard in health insurance: what we know and how we know it","volume":"16","author":"Einav","year":"2018","journal-title":"J. Eur. Econ. Assoc."},{"issue":"2","key":"10.1016\/j.socscimed.2026.119899_bib9","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/0167-6296(86)90002-0","article-title":"Provider behavior under prospective reimbursement: cost sharing and supply","volume":"5","author":"Ellis","year":"1986","journal-title":"J. Health Econ."},{"issue":"3","key":"10.1016\/j.socscimed.2026.119899_bib10","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1093\/qje\/qjs020","article-title":"The Oregon Health insurance Experiment: evidence from the first year","volume":"127","author":"Finkelstein","year":"2012","journal-title":"Q. J. Econ."},{"key":"10.1016\/j.socscimed.2026.119899_bib11","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1186\/s12913-018-3369-2","article-title":"Understanding reasons for unmet health care needs in Korea: what are health policy implications?","volume":"18","author":"Hwang","year":"2018","journal-title":"BMC Health Serv. Res."},{"issue":"1\u20132","key":"10.1016\/j.socscimed.2026.119899_bib12","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.healthpol.2013.05.007","article-title":"Effect of private health insurance on health care utilization in a universal public insurance system: a case of South Korea","volume":"113","author":"Jeon","year":"2013","journal-title":"Health Policy"},{"issue":"1","key":"10.1016\/j.socscimed.2026.119899_bib13","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1377\/hlthaff.2008.0816","article-title":"Korea's National Health Insurance\u2014Lessons from the past three decades","volume":"30","author":"Jeong","year":"2011","journal-title":"Health Aff."},{"key":"10.1016\/j.socscimed.2026.119899_bib14","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.3346\/jkms.2012.27.S.S21","article-title":"Sustainability of Korean national health insurance","volume":"27","author":"Kang","year":"2012","journal-title":"J. Kor. Med. Sci."},{"key":"10.1016\/j.socscimed.2026.119899_bib15","series-title":"Social Epidemiology","first-page":"174","article-title":"Social cohesion, social capital, and health","author":"Kawachi","year":"2000"},{"issue":"3","key":"10.1016\/j.socscimed.2026.119899_bib16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0119939","article-title":"The differences in health care utilization between medical aid and health insurance: a longitudinal study using propensity score matching","volume":"10","author":"Kim","year":"2015","journal-title":"PLoS One"},{"issue":"4","key":"10.1016\/j.socscimed.2026.119899_bib17","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-009538","article-title":"Impact of health insurance status changes on healthcare utilisation patterns: a longitudinal cohort study in South Korea","volume":"6","author":"Kim","year":"2016","journal-title":"BMJ Open"},{"issue":"2","key":"10.1016\/j.socscimed.2026.119899_bib18","doi-asserted-by":"crossref","first-page":"44","DOI":"10.14371\/QIH.2019.25.2.44","article-title":"Impact of changes in Medical Aid status on unmet need and catastrophic health expenditure: data from the Korea Health Panel","volume":"25","author":"Kim","year":"2019","journal-title":"Qual. Improv. Health Care"},{"key":"10.1016\/j.socscimed.2026.119899_bib19","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1186\/s12889-020-09073-x","article-title":"Factors influencing health care use by health insurance subscribers and medical aid beneficiaries: a study based on data from the Korea welfare panel study database","volume":"20","author":"Kong","year":"2020","journal-title":"BMC Public Health"},{"issue":"1","key":"10.1016\/j.socscimed.2026.119899_bib20","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1093\/heapol\/czn037","article-title":"Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage","volume":"24","author":"Kwon","year":"2009","journal-title":"Health Pol. Plann."},{"key":"10.1016\/j.socscimed.2026.119899_bib21","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1186\/s12913-020-05778-2","article-title":"The effect of shifting medical coverage from National health Insurance to Medical Aid type I and type II on health care utilization and out-of-pocket spending in South Korea","volume":"20","author":"Lee","year":"2020","journal-title":"BMC Health Serv. Res."},{"issue":"4","key":"10.1016\/j.socscimed.2026.119899_bib22","first-page":"685","article-title":"Optimal health insurance and provider payment","volume":"87","author":"Ma","year":"1997","journal-title":"Am. Econ. Rev."},{"issue":"5","key":"10.1016\/j.socscimed.2026.119899_bib23","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/S0167-6296(96)00497-3","article-title":"Health insurance: the tradeoff between risk pooling and moral hazard","volume":"15","author":"Manning","year":"1996","journal-title":"J. Health Econ."},{"key":"10.1016\/j.socscimed.2026.119899_bib24","first-page":"461","article-title":"Physician agency","volume":"vol. 1","author":"McGuire","year":"2000"},{"issue":"2","key":"10.1016\/j.socscimed.2026.119899_bib25","doi-asserted-by":"crossref","first-page":"147","DOI":"10.2307\/2137009","article-title":"Medical sociology: some tensions among theory, method, and substance","volume":"30","author":"Mechanic","year":"1989","journal-title":"J. Health Soc. Behav."},{"key":"10.1016\/j.socscimed.2026.119899_bib26","series-title":"2025 Health and Welfare Statistical Yearbook","year":"2025"},{"issue":"3","key":"10.1016\/j.socscimed.2026.119899_bib27","first-page":"531","article-title":"The economics of moral hazard: comment","volume":"58","author":"Pauly","year":"1968","journal-title":"Am. Econ. Rev."},{"issue":"11","key":"10.1016\/j.socscimed.2026.119899_bib28","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data","volume":"43","author":"Quan","year":"2005","journal-title":"Med. Care"},{"key":"10.1016\/j.socscimed.2026.119899_bib29","series-title":"The Economics of Health Reconsidered","author":"Rice","year":"2009"},{"issue":"10","key":"10.1016\/j.socscimed.2026.119899_bib30","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1111\/j.1365-2648.2010.05364.x","article-title":"Medical aid service overuse assessed by case managers in Korea","volume":"66","author":"Shin","year":"2010","journal-title":"J. Adv. Nurs."},{"issue":"4","key":"10.1016\/j.socscimed.2026.119899_bib31","doi-asserted-by":"crossref","first-page":"408","DOI":"10.3390\/healthcare8040408","article-title":"Unmet healthcare needs, catastrophic health expenditure, and health in South Korea's universal healthcare system: progression towards improving equity by NHI type and income level","volume":"8","author":"Sohn","year":"2020","journal-title":"Healthcare"},{"issue":"10","key":"10.1016\/j.socscimed.2026.119899_bib32","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1001\/jamainternmed.2016.4419","article-title":"Changes in utilization and health among low-income adults after Medicaid expansion or expanded private insurance","volume":"176","author":"Sommers","year":"2016","journal-title":"JAMA Intern. Med."},{"issue":"10","key":"10.1016\/j.socscimed.2026.119899_bib33","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.0040297","article-title":"Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration","volume":"4","author":"Vandenbroucke","year":"2007","journal-title":"PLoS Med."},{"issue":"7","key":"10.1016\/j.socscimed.2026.119899_bib34","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1016\/j.socscimed.2005.08.036","article-title":"Income inequality and population health: a review and explanation of the evidence","volume":"62","author":"Wilkinson","year":"2006","journal-title":"Soc. Sci. Med."},{"issue":"1","key":"10.1016\/j.socscimed.2026.119899_bib35","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/0022-0531(70)90010-4","article-title":"Medical insurance: a case study of the tradeoff between risk spreading and appropriate incentives","volume":"2","author":"Zeckhauser","year":"1970","journal-title":"J. Econ. Theor."}],"container-title":["Social Science & Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0277953626009779?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0277953626009779?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:34:07Z","timestamp":1792092847000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0277953626009779"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,12]]},"references-count":35,"alternative-id":["S0277953626009779"],"URL":"https:\/\/doi.org\/10.1016\/j.socscimed.2026.119899","relation":{},"ISSN":["0277-9536"],"issn-type":[{"value":"0277-9536","type":"print"}],"subject":[],"published":{"date-parts":[[2026,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Medical need or moral hazard? Public insurance transitions and healthcare utilization in South Korea","name":"articletitle","label":"Article Title"},{"value":"Social Science & Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.socscimed.2026.119899","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"119899"}}